Improving pilots’ tactical decisions in air combat training using the critical decision method

In fighter pilot training, much of upgrade pilots’ (UPs’) learning takes place during mission debriefs. A debrief provides instructor pilots (IPs) the opportunity to correct situation awareness (SA) upon which the UPs base their tactical decisions. Unless the debrief is conducted with proper depth and breadth, the IPs’ feedback on UPs’ SA and tactical decision-making may be incomplete or false, resulting in poor, or even negative learning. In this study, a new debrief protocol based on the Critical Decision Method (CDM) is introduced. The protocol specifically addresses the SA of UPs. An evaluation was conducted to examine if a short CDM training programme to IPs would enhance their ability to provide performance feedback to UPs regarding their SA and tactical decision-making. The IPs were qualified flying instructors and the UPs were air force cadets completing their air combat training with BAe Hawk jet trainer aircraft. The impact of the training intervention was evaluated using Kirkpatrick’s four-level model. The first three levels of evaluation (Reactions, Learning and Behaviour) focused on the IPs, whereas the fourth level (Results) focused on the UPs. The training intervention had a positive impact on the Reactions, Learning and debrief Behaviour of the IPs. In air combat training missions, the UPs whose debriefs were based on the CDM protocol, had superior SA and overall performance compared to a control group.<br/

Dual inhibition of tumour necrosis factor and interleukin-17A with ABT-122: open-label long-term extension studies in rheumatoid arthritis or psoriatic arthritis.

Objectives: To evaluate the safety and maintenance of efficacy with ABT-122, a bi-specific monoclonal antibody targeting TNF and IL-17A, in patients with RA or PsA in open-label, 24-week extensions [open-label extensions (OLEs)] of 12-week, randomized, double-blind studies. Methods: All patients received ABT-122 (RA, 120 mg; PsA, 240 mg) subcutaneously every other week on background MTX. Safety assessments included adverse events (AEs) and laboratory parameters. Efficacy was evaluated with ACR responses, 28-joint DAS using high-sensitivity CRP [DAS28 (hsCRP)], and Psoriasis Area and Severity Index (PsA study). Results: The RA OLE study enrolled 158 patients; the PsA OLE study enrolled 168 patients. In the RA OLE study, the incidence of treatment emergent AEs (TEAEs; 41%) appeared similar to the double-blind study (36-43%). In the PsA OLE study, 57% of patients reported ⩾1 TEAE (double-blind study, 42-53%). Most TEAEs were mild or moderate in severity. There were no neutrophil abnormalities greater than grade 2. Grade 3 and/or 4 laboratory abnormalities were reported for lymphocytes, alanine aminotransferase, aspartate aminotransferase, bilirubin and haemoglobin; the number of these severe laboratory values was low (0.6-3.0%), except grade 3 lymphocyte count decreased (11.5%) in the RA study. In both OLE studies, efficacy assessed by ACR responses and other disease activity scores was maintained over the 24 weeks. Conclusion: ABT-122 demonstrated acceptable tolerability and maintenance of efficacy for up to 36 weeks in patients with RA or PsA receiving background MTX. Trial registration: ClinicalTrials.gov, http://clinicaltrials.gov, NCT02433340 and NCT02429895